Honey and Health

The relationship between honey and health is limited to a few well-studied areas, such as honey's nutritional value, the use of medical-grade honey in wound care and its effect on cough symptoms in children; for many other claims the evidence is insufficient. Honey is a valuable food, but it is not a medicine. Honey must not be given to babies under one year old, and some special honeys such as mad honey can cause poisoning.

What is honey made of?

Honey is a product that bees make by collecting flower nectar or plant secretions (honeydew honey, for example pine honey), processing them with enzymes and ripening them by evaporating their water. Most of its weight is sugar: mainly fructose and glucose, with smaller amounts of other sugars such as maltose and sucrose.

• Water: In ripe honey usually below 20%; the higher the water content, the greater the risk of fermentation.
• Enzymes: Invertase, diastase and glucose oxidase, added by the bees. Glucose oxidase produces small amounts of hydrogen peroxide when honey is diluted.
• Organic acids: These make honey slightly acidic.
• Trace components: Minerals, small amounts of vitamins, phenolic compounds and pollen. Dark honeys generally contain more phenolic compounds.

Nutritionally, although honey carries slightly more trace substances than table sugar, it is essentially a concentrated source of energy and sugar. Its vitamin and mineral content is small relative to daily requirements.

Why doesn't honey go off? Its antimicrobial properties

Ripe honey can keep for years at room temperature without spoiling. The reasons are well known:

1. High sugar concentration: It draws water out of the cells of microorganisms (osmotic effect).
2. Low water activity: Most bacteria cannot multiply.
3. Acidity: It limits microbial growth.
4. Hydrogen peroxide: Formed by the action of the enzyme glucose oxidase when honey is diluted.
5. Plant-derived components: Some honeys contain additional factors; for example New Zealand's manuka honey is high in methylglyoxal.

These properties have been demonstrated in the laboratory. But this does not mean that honey stirred into a glass of hot water "kills germs" in the body; these conditions do not arise in the stomach or bloodstream.

Is honey used in wound care?

The use of honey in wound care is the area with the most clinical research among bee products. Some studies suggest it may help healing in certain types of wound and in burns; however, the quality of the studies varies.

There is a crucial distinction here: the medical-grade honey used for this purpose is produced under controlled conditions, usually sterilised by irradiation, standardised and licensed as a medical device. Raw table honey is not the same thing; because it can carry microbial spores, it must not be applied to open wounds, burns or surgical wounds.

Is honey good for a cough?

Cough due to colds in children is the most frequently cited use of honey. Reviews show that in children over one year old, honey given before bedtime may somewhat ease night-time coughing and sleep disturbance compared with no treatment; the level of evidence is moderate to low. Here honey acts as a soothing substance that coats the throat; it does not treat the cause of the cough.

With a long-lasting cough, high fever, shortness of breath or wheezing, do not rely on honey; see a doctor.

Claims about honey with weak evidence

Many claims circulating about honey come from laboratory or animal studies: preventing cancer, lowering cholesterol, boosting immunity, treating ulcers and so on. There are no strong studies showing these effects in humans. The right thing to say is therefore "there are preliminary findings, but the evidence is limited".

The often-heard claim that "honey is harmless for diabetics" is also wrong. Honey raises blood sugar; people with diabetes should plan their intake with a doctor or dietitian.

Who is honey risky for? Safety rules

• Babies under one year: Clostridium botulinum spores, which can be present in honey, can multiply in a baby's gut and produce toxin, leading to infant botulism. This condition, marked by muscle weakness, constipation, weak sucking and breathing difficulty, is life-threatening. A baby under one year must not be given honey, a dummy dipped in honey, or food made with honey.
• Mad honey (rhododendron honey from the Black Sea region): The nectar of some Rhododendron species contains grayanotoxins, which can cause dizziness, nausea, vomiting, sweating, a slow pulse and a drop in blood pressure. With these symptoms, go to an emergency department. Mad honey should not be taken as a "medicine".
• Diabetes and weight control: Honey is a concentrated source of sugar and energy.
• Allergy: Rare; usually linked to pollen or bee-derived proteins in the honey. People allergic to pollen or bee products should be careful.

What makes honey good from a health point of view?

The consumer's health is directly linked to the beekeeper's harvesting and processing practices.

• Harvesting ripe honey: Honey taken before most of the frame is capped has a high water content and ferments.
• Residue-free production: Varroa treatments are used only with licensed products, only when the honey supers are off the hive and in line with the label's withdrawal period. Antibiotics are not used.
• No overheating: Crystallised honey should be liquefied slowly in a warm water bath at a low temperature (generally not above 40 °C). In overheated honey the enzymes are destroyed and HMF (hydroxymethylfurfural), an indicator of ageing/heat treatment, rises.
• Appropriate straining: Coarse straining removes wax and bee fragments; excessively fine filtering reduces the ability to identify the honey's pollen profile and origin.
• Clean containers and surroundings: Food-grade containers with tight-fitting lids are used.

Crystallisation is not spoilage

The belief that "honey that sets has had sugar added" is wrong. The rate of crystallisation depends on the honey's glucose/fructose ratio, its water content and the storage temperature. Honeys such as sunflower and rapeseed crystallise quickly, while honeys such as acacia and chestnut crystallise slowly.

How should honey be stored?

• A closed container: Honey absorbs moisture from the air; honey left with the lid off can take up water and ferment.
• Room temperature, in the shade: Hot places such as direct sunlight or next to the cooker are unsuitable.
• No need for the fridge: Crystallisation speeds up in the cold; this is not harmful but makes the honey harder to use.
• A dry spoon: A wet spoon carries water and yeast into the honey.

What can a beekeeper say when selling honey?

In Türkiye, food labelling legislation prohibits attributing to foods the property of preventing, treating or curing disease; this rule also applies to advertising and social media promotion. Expressions such as "healing honey" or "take it as medicine" are therefore risky.

Safe, trustworthy promotion includes the type of honey, its region, the harvest time, analysis results, storage conditions and the warning "not to be given to babies under 1 year".